All about colonoscopy

1. Colonoscopy
is a procedure that uses a long, flexible, narrow tube with a light and tiny
camera on one end, called a colonoscope or scope, to look inside the rectum and entire
colon. Colonoscopy can show irritated and swollen tissue, ulcers, and polyps—extra
pieces of tissue that grow on the lining of the intestine. A gastroenterologist—a doctor
who specializes in digestive diseases—performs this procedure.
This procedure is different from virtual colonoscopy, which uses a combination of
x rays and computer technology to create images of the rectum and entire colon.
Indication
A colonoscopy is performed to help diagnose
• changes in bowel habits
• abdominal pain
• bleeding from the anus
• weight loss
A gastroenterologist also performs a colonoscopy as a screening test for colon
cancer. Screening is testing for diseases when people have no symptoms. Screening
may find diseases at an early stage, when a health care provider has a better chance of
curing the disease.
Preparation
*Take the informed written consent after explaining the procedure ,outcomes and risks
complete bowel preparation is required.
*Put the patient on a low fiber diet from about 3 days prior to procedure
*On the day before the procedure prepare the bowel with Polyethylene glycol (PEG)
*Ask the patient to dissolve one sachet in a liter of water and drink it over a period of 1 hour
Then wait for 1h and repeat the same
*Use about 3 sachets
*Only clear fluid allowed after these cycle are completed
• Talk with a gastroenterologist. When people schedule a colonoscopy, they should talk with
their gastroenterologist about medical conditions they have and all prescribed and over-the-
counter medications, vitamins, and supplements they take, including
– aspirin or medications that contain aspirin
– nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen
– arthritis medications
– blood thinners

2. – diabetes medications
– vitamins that contain iron or iron supplements
• Arrange for a ride home after the procedure. Driving is not allowed for 24 hours after the
procedure to allow time for the anesthesia to wear off.
• Cleanse the bowel. The gastroenterologist will give written bowel prep instructions
to follow at home. A gastroenterologist orders a bowel prep so that little to no stool is present
inside the person’s intestine. A complete bowel prep lets the person pass stool that is clear.
Stool inside the colon can prevent the gastroenterologist from clearly seeing the lining of the
intestine. Instructions may include following a clear liquid diet for 1 to 3 days before the
procedure.
*and avoiding drinks that contain red or purple dye. The instructions will provide specific
direction about when to start and stop the clear liquid diet.
People may drink or eat the following:
– fat-free bouillon or broth
– strained fruit juice, such as apple or white grape—orange juice is not recommended
– water
– plain coffee or tea, without cream or milk
– sports drinks in flavors such as lemon, lime, or orange
– gelatin in flavors such as lemon, lime, or orange
The person needs to take laxatives and enemas the night before a colonoscopy. A laxative is
medication that loosens stool and increases bowel movements. An enema involves flushing
water or laxative into the rectum using a special wash bottle. Laxatives and enemas can cause
diarrhea, so the person should stay close to a bathroom during the bowel prep.
Laxatives are usually swallowed in pill form or as a powder dissolved in water. Some people will
need to drink a large amount, usually a gallon, of liquid laxative at scheduled times. People may
find this part of the bowel prep difficult; however, it is very important to complete the prep.
The gastroenterologist will not be able to see the colon clearly if the prep is incomplete.
People should call the gastroenterologist if they are having side effects that are preventing
them from finishing the prep.
Procedure
*The medical staff will monitor people’s vital signs and try to make people as comfortable as
possible.
A nurse or technician places an intravenous (IV) needle in a vein in the arm to give anesthesia.
Fentanyl revers by Naloxone
Dormicum (Midazolam) reverse by Flumazenile
*For the test, the person will lie on a table while the gastroenterologist inserts a colonoscope
into the anus and slowly guides it through the rectum and into the colon. The scope inflates the
large intestine with air to give the gastroenterologist a better view. The camera sends a video

3. image of the intestinal lining to a computer screen, allowing the gastroenterologist to
carefully examine the intestinal tissues. The gastroenterologist may move the person
several times so the scope can be adjusted for better viewing. Once the scope has
reached the opening to the small intestine, the gastroenterologist slowly withdraws it and
examines the lining of the large intestine
again.
The gastroenterologist can remove polyps during colonoscopy and send them to a lab
for testing. Polyps are common in adults and are usually harmless. However, most colon
cancer begins as a polyp, so removing polyps early is an effective way to prevent cancer.
The gastroenterologist may also perform a biopsy, a procedure that involves taking
a small piece of intestinal lining for examination with a microscope. The person will not feel the
biopsy. A pathologist—a doctor who specializes in diagnosing diseases—will examine the tissue.
The gastroenterologist may pass tiny tools through the scope to remove polyps and take a
sample for biopsy. If bleeding occurs, the gastroenterologist can usually stop it with an
electrical probe or special medications passed through the scope. Colonoscopy usually takes 30
to 60 minutes.
After the colonoscopy, a person can expect the following:
• People may need to stay at the hospital or outpatient center for 1 to 2 hours after the
procedure.
• Cramping or bloating may occur during the first hour after the test.
• The anesthesia takes time to completely wear off.
• Full recovery is expected by the next day, and people should be able to go back to their
normal diet.
Complication
• bleeding.
• perforation—a hole or tear in the lining of the colon.

4. • diverticulitis—a condition that occurs when small pouches in the colon, called diverticula,
become irritated, swollen, and infected.
• cardiovascular events, such as a heart attack, low blood pressure, or the heart skipping beats
or beating too fast or too slow.
• severe abdominal pain.
• death, although this risk is rare.